Socio-demographic characteristics of participants
A total of 642 adolescent students have participated in the study which makes a response rate of 92.7%. From the total respondents, 63.7% respondents were male students with the mean age of 17.71 years SD (± 1.19) and more than half, 57.6%, were grade 9 and 10. From the total participants 75.1% were single and 86.1% were Muslims. Regarding the living arrangement of students, most of them, 81.5%, were living with their families (Table 1).
Secondary school adolescents’ characteristics
Of the total adolescents participated in the study 39% ever had a boy or girlfriend and 20% of were sexually active. 68.5% of participating adolescents reported that had been exposed to SRH information with 52% mentioned peers as the main source of information. Regarding discussion of SRH issues 62.2% respondents ever discussed at least two SRH issues: 42.6% discussed with peers followed by 19.8% discussed with healthcare providers (Table 2).
From all respondents, more than half of 56.1% knew health facilities that provide SRH services and 66.7% knew SRH service types. Out of these respondents, 90.9% knew VCT services, 73.1% knew contraceptive services and 29.0% knew safe abortion services (Table 3).
Utilization of SRH services
Overall, 23.5% (95% CI: 20, 26.8) of in-school adolescents utilized SRH services (64.2% male and 35.8% female students) in Haramaya district. The most frequently used SRH services components were counseling, information, and education, followed by VCT & HIV testing (Fig. 1). Of 132 sexually experienced adolescents, 42.4% used SRH services, of which 46.2% were married. Among adolescents who utilized SRH services, 41% did not want to return to the health facility. The main reasons for not wanting to return to health facilities were: not having enough privacy 28(45%), too embracing 13(21%), and no healthcare provider of same sex (14.5%) (Fig. 2).
Factors associated with utilization of SRH
A binary logistic regression model was used to identify factors associated with utilization of SRH services. Based on the estimates from the bivariable binary logistic regression model, the factors significantly associated with utilization of SRH were age, marital status, living arrangement, having own income, ever had sexual intercourse, ever exposed to SRH information, discussion of SRH issues, perceived SRH risks, know of RH facility, aware of RH services, and being far at distant from the facility. All variables that showed association in the bivariable model are entered into the multivariable binary logistic regression model. Controlling for the effect of other variables in the model, adolescents with the following characteristics were over two-fold more likely to use SRH services: exposure for information (AOR = 2.11, 95% CI: 1.22–3.66), awareness of SRH services(AOR = 2.76 95%, CI: 1.53–4.97), identifying SRH facility whereabouts (AOR = 1.83 95% CI: 1.12–3.0), and far from SRH clinics (AOR = 2.28 95%, CI: (1.13–4.62) showed statistically significant association at p-value < 0.05 (Table 4).